Creating change, challenging structure: graduate and faculty perspectives on the implementation of an interprofessional education program in veterans affairs primary care.

Interprofessional clinical education programs have the potential to impact participants' professional expectations and practices related to team-based care. In this qualitative study, research team members interviewed 38 graduates and 19 faculty members from such an interprofessional training program, the Department of Veterans Affairs (VA) Centers of Excellence in Primary Care Education (CoEPCE). Semi-structured interviews with participants enquired about skills gained, impact on career expectations, and barriers to implementing interprofessional skills in the post-training workplace. Data were coded and analyzed using a hybrid inductive/deductive approach. Participants perceived that the program was successful in creating new norms of flattened team hierarchies, broadening graduates' understanding of role interaction, and teaching interactional skills involving teamwork. Participants reported organizational and systemic barriers to changing existing primary care practice. Interprofessional clinical education programs may help new professionals recognize and act on opportunities for improvement in existing practice. Healthcare employers must recognize changed expectations and provide opportunities for interprofessional collaboration to attract graduates from such programs.